Provider Demographics
NPI:1962027862
Name:CUMPTON, KAYLA (LMSW)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:CUMPTON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6460 NE 551 RD
Mailing Address - Street 2:
Mailing Address - City:OSCEOLA
Mailing Address - State:MO
Mailing Address - Zip Code:64776-8212
Mailing Address - Country:US
Mailing Address - Phone:660-464-0943
Mailing Address - Fax:
Practice Address - Street 1:855 ARDUSER DR
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:MO
Practice Address - Zip Code:64776-6278
Practice Address - Country:US
Practice Address - Phone:417-646-5075
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-16
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020014594101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor